Provider Demographics
NPI:1174576060
Name:MORI, HAYATO (MD)
Entity type:Individual
Prefix:
First Name:HAYATO
Middle Name:
Last Name:MORI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 N KUAKINI ST STE 408
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2380
Mailing Address - Country:US
Mailing Address - Phone:808-531-0663
Mailing Address - Fax:808-534-1551
Practice Address - Street 1:321 N KUAKINI ST STE 408
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2380
Practice Address - Country:US
Practice Address - Phone:808-531-0663
Practice Address - Fax:808-534-1551
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-10308207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIC021518-0OtherHMSA
HI08818603Medicaid
HIC021518-0OtherHMSA
HI08818603Medicaid